OrganizationActive
Southeast Missouri Health Network
NPI 1013229749 · General Practice Dentistry · Kennett, MO
Provider details
- NPI number
- 1013229749
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Chris Jones, Chief Executive Officer(573) 748-2404
Specialties & taxonomies
Dental Providers
- Federally Qualified Health Center (FQHC)261QF0400X
Ambulatory Health Care Facilities
Profile Score
Detailed profile(83/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
500 Russell St
Kennett, MO 63857-2102
Phone: (573) 888-3000
Fax: (573) 888-3003
Street-level locationGet directions
Mailing address
420 Semo Dr
New Madrid, MO 63869-1734
Other names (DBA / former)
- Doing business as
- Otto Bean Dental Clinic
Registry dates
- Enumerated
- 2010-07-10
- Last updated
- 2014-08-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.